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23.11.2021 | Thoracic Oncology

Clinical Significance of Endoscopic Response Evaluation to Predict the Distribution of Residual Tumor after Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

verfasst von: Satoru Matsuda, MD, PhD, Hirofumi Kawakubo, MD, PhD, Takayuki Tsuji, MD, Junya Aoyama, MD, PhD, Yuki Hirata, MD, Ryo Takemura, PhD, Shuhei Mayanagi, MD, PhD, Tomoyuki Irino, MD, PhD, Kazumasa Fukuda, MD, Rieko Nakamura, MD, PhD, Hiroya Takeuchi, MD, PhD, FACS, Yuko Kitagawa, MD, PhD, FACS

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2022

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Abstract

Purpose

To appropriately adopt the organ preservation approach, including subsequent chemoradiotherapy (CRT) in patients who respond to neoadjuvant chemotherapy (NAC), the distribution of residual disease, including pathological lymph nodes (LNs) and recurrence site, needs to be recognized preoperatively. This study was designed to evaluate whether endoscopic response evaluation can predict residual tumor distribution.

Methods

Patients with esophageal squamous cell carcinoma who underwent transthoracic esophagectomy (TTE) were retrospectively reviewed. Endoscopic responder (ER) to NAC was defined according to primary tumor endoscopic findings. Recurrence-free survival (RFS), overall survival (OS), and residual tumor patterns were compared between groups.

Results

Of 193 patients, 40 (20%) were classified as ER. ERs showed significantly better RFS and OS. The pN location was found within the primary tumor and cN field in 88% of ERs, which was significantly higher than non-ERs at 63% (p = 0.004). Furthermore, the postoperative recurrence incidence in the distant organ was significantly lower in the ERs than the non-ERs (8%, 32%, respectively, p = 0.002). Residual disease, including postoperative initial recurrence, existed within the same field as the primary tumor and cN in 88% of ERs, significantly higher than 42% in the non-ERs (p < 0.001).

Conclusions

Endoscopic response evaluation can preoperatively predict distribution of residual tumors after NAC, which could help radiation field selection in subsequent definitive CRT when patients prefer to omit TTE. Along with improvements in NAC response rate, this could facilitate organ preservation in patients who respond to NAC.
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Metadaten
Titel
Clinical Significance of Endoscopic Response Evaluation to Predict the Distribution of Residual Tumor after Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma
verfasst von
Satoru Matsuda, MD, PhD
Hirofumi Kawakubo, MD, PhD
Takayuki Tsuji, MD
Junya Aoyama, MD, PhD
Yuki Hirata, MD
Ryo Takemura, PhD
Shuhei Mayanagi, MD, PhD
Tomoyuki Irino, MD, PhD
Kazumasa Fukuda, MD
Rieko Nakamura, MD, PhD
Hiroya Takeuchi, MD, PhD, FACS
Yuko Kitagawa, MD, PhD, FACS
Publikationsdatum
23.11.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-11009-7

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